Trigger Point Dry Needling Common Questions

Dry Needling involves multiple advances of a filament needle into the muscle in the region of a "Trigger Point'. The aim of Dry Needling is to achieve a local twitch response to release muscle tension and pain. Dry needling is an effective treatment for chronic pain of neuropathic origin with very few side effects. This technique is unequalled in finding and eliminating neuromuscular dysfunction that leads to pain and functional deficits. The needle used is very thin and most subjects do not even feel it penetrate the skin. A healthy muscle feels very little discomfort with insertion of this needle. However if the muscle is sensitive and shortened or has active trigger points within it, the subject will feel a sensation like a muscle cramp -'the twitch response'. The patient also may feel a reproduction of "their" pain which is a helpful diagnostic indicator for the practitioner attempting to diagnose the cause of the patients symptoms. Patients soon learn to recognise and even welcome this sensation as it results in deactivating the trigger point, reducing pain and restoring normal length function to the involved muscle.

Prior knowledge or experience of Dry Needling is not essential for successful completion of the Level One course. However, having completed the basic courses previously available in your territory will be of benefit.

These courses are ideal for graduates of schools of Physiotherapy, Osteopathy and Chiropractic. This course is also ideal for practitioners who have experience in the evaluation and treatment of acute and chronic pain disorders as well as those clinicians who are seeking alternative, immediate and effective treatment options for the athletic population.

There is a requirement of a minimum of 2 years of clinical experience before registering for the level I TDN course.

These courses have been approved and accredited by both the New Zealand and Australian Physiotherapy Associations. This means the course contents and objectives have been scrutinised by these associations who have endorsed their content and learning objectives. It means that Physiotherapists planning to participate in this course will be certified to perform Dry Needling techniques on their patients immediately following the workshops. Physiotherapists will receive a total of 52 CPD points for the Level One course and approximately 34 CPD points for the Level Two course. Other professions will need to check with their association to ascertain applicable CPD points.

In the US, the GEMt TDN courses are the only one of two accepted courses of education for dry needling. In Colorado, the GEMt Dry Needling courses are specifically endorsed by the Department of Regulatory Agencies.  Physical therapists completing their initial Level I training can practice dry needling, of the muscles instructed in Level I, while completing their needling log in order to qualify for the Level II course.  Participants must complete their log of 200 patients and submit it to course instructors prior to qualifying for Level II instruction.  Colorado physical therapists must complete their training within 6-8 months of starting their training per Colorado's specific rules and regulations.  GEMt will attempt to schedule Level II courses at times that will coincide with the 6-8 month time constraint for Level I trained course participants.  Trigger Point Dry Needling is pending or has currenly been accepted in the scope of practice for physical therapists in the following states; Alabama (pending), Colorado, Georgia, Maryland, New Hampshire, New Mexico, Nevada (EMG is allowed, further investigation is ongoing for Dry Needling), South Carolina, Texas, and Virginia.  If you are interested in pursuing TDN being allowed in your state please contact us as we may be able to assist you in doing so.

There is currently one other series of courses in the US where Physical Therapists can receive education in trigger point dry needling.  www.myopainseminars.com

Does this course count toward Continuing Education Units?

The Level I course has been approved for 2.15 CEU's in Houston and is currently under review in Nevada. The course is approximately 23 contact hours.

Can I still take the course if my state does not list TDN in the PT scope of practice?

You may still take the course but it will be your responsibility to know the laws and regulations for your state. if you are interested in persuing the process of getting TDN accepted in your state, let the GEMt staff know and we will assist you in any way we can.

Successful completion of the Level I course will provide you with skills and knowledge to begin utilizing the treatment immediatly.  If you plan to take the level II course or are practicing in Colorado, it is required that you log performance of the TDN treatment on a minimum of 200 subjects before taking the level II course.  Please note if you are practicing in Colorado it is required that you take a level II course within 6 months of completing the level I course, and if level II is not completed you must cease performing the TDN technique.

The quick answer for this is YES.  However, payment is dependent on the sate you practice in and your specific insurance contracts.  This topic is covered more thouroughly in the courses regarding some of the variables you may encounter with billing.

The focus of the level I course is treatment for pain management and sport related injuries. Participants successfully completing the Level One and Two courses will be able to treat pain and dysfunction originating from myofascial active trigger points that can lead to conditions such as; tendonopathies, movement impairments and other orthopaedic and sporting conditions of the following areas:

Level I	Level II
Hip	Advanced Hip
Lumbar Spine	Advanced Lumbar Spine
Thigh	TMJ/Face
Cervical Spine	Advanced Cervical Spine
Shoulder	Thoracic Spine
Upper and Lower Extremity	Advanced Upper and Lower Extremity

The most common cause of nerve irritation and neuropathic pain is underlying spinal degeneration (i.e. spondylosis of the spine), which can be a result of trauma and/or normal wear and tear. Spondylosis irritates the nerve root and leads to neuropathy which can result in muscle shortening. This process leads to pain and dysfunction in many common acute and chronic conditions that practitioners see in every day practice. The introduction of a dry needle into the active trigger sites of these muscles can provide enormous relief of symptoms.

Dry Needling may also be used for acute and chronic sporting injuries such as:

• Muscular haematomas
• Muscle tears
• Compartment syndrome
• Medial tibial stress syndrome (shin splints)
• Rotator cuff injuries
• Tennis/golfers elbow

The application of Dry Needling techniques for the above conditions will be demonstrated during these courses.  In level II, participants will be instructed in advanced techniques which will include the use of a needle plunger. The level II is considered advance based on the learning outcomes gained in level I and/or for safety reasons.

Dry Needling can also be used for spinal conditions where the underlying pathology may have triggered a movement disorder. This can result in the presence of reduced ROM or pain due to abnormal muscle tone or spasms. Such conditions may include:

• Piriformis syndrome
• Cervico-genic headaches
• Sciatica
• Hamstring issues

Common lower extremity conditions treated with Dry Needling include:

• Patellar Femoral Syndrome
• Patellar tendonitis
• Hamstring Strain
• Groin Strain
• Shin-splints; Compartment Syndrome
• Achilles tendonopathies

Common upper extremity conditions treated with Dry Needling include:

• Thoracic Outlet Syndrome
• Carpal Tunnel Syndrome
• Lateral Epicondylitis (tennis elbow)
• Medial Epicondylitis (golfers elbow) 
• Impingement syndromes

Currently Colorado DORA is the only State that requires both Level I and Level II to be completed before considering a PT independently able to perform the technique. Therefore, it is optional for PTs practicing in states other than Colorado to take the Level II TDN course. You do not have to register for both courses at the same time.  Per DORA Colorado practicing PTs must complete and log performing TDN on 200 subjects and complete the Level II course within approximately 6 months of completing level I to continue performing the technique and be within the scope guidelines.

All course participants will be provided with an extensive illustrated course manual describing and depicting all the theory and course material covered during the 2 or 3 day workshops. All participants will also take away a starter pack (Level One) inclusive of a 'sharps container' and quality Sensei needles allowing you to effectively administer Dry Needling in your practice immediately following the completion of the course.

Level Two participants will receive a comprehensive manual as well as a needle plunger used for advanced techniques.

You will also be provided with pre-reading material to prepare you for the course.

Supplies used for TDN and therapy treatment will also be available for purchase at the end of the course and through our website.

GEMt courses boast having the best cuisine available for its course participants. Healthy food for a healthy mind! A main course meal will be provided each day of the course.

You will receive a certificate of completion once you attend the course and successfully pass the course exams.  This is not technically a certification as a recognized and accredited university or school would issue such. The certiificate will list your name, where and when the course occurred and the amount of contact hours (23 for each TDN course, 46 for both Level I and Level II).  If the course is approved for CE units those will be listed as well.  See FAQ's page for updated news regarding accredidation and approved CEUs.

The main product you will need to perform TDN is filament needles. You will receive a starter pack of needles when you attend the course.   At the completion of the course there will be the opportunity to purchase more needles or you can visit our website under products.  At the time of the course we will also provide you with detailed contact information of the company that sponsored the needle supply and you can then order directly through them at a discounted rate.  (It does not require a physicians prescription to purchase needles). There are some other optional products that can aide in the technique which will also available for purchase.

The level I dry needling course is designed to prepare the trainee to practice dry needling immediately upon returning to the clinic Monday morning.  Theoretical and practical testing will be administered during the Sunday session and participants will be expected to display an appropriate level of competency prior to receiving their course certificate.